论文部分内容阅读
目的：探讨肝动脉内植入药盒导管系统（ＰＣＳ）的最佳径路。材料与方法：２１６例中晚期肝癌，１１８例采取经皮左锁骨下动脉（ＬＳＡ）径路肝动脉内植入ＰＣＳ，另外９８例采取经皮股动脉（ＦＡ）径路植入ＰＣＳ。统计两种植入方法的成功率、并发症。结果：ＬＳＡ组与ＦＡ组植入成功率分别为９１．５％和８８．７％（Ｐ＞０．０５）。ＬＳＡ组植入失败的１０例为动脉穿刺失败８例，靶动脉迂曲留置管无法置入２例；ＦＡ组失败１１例均为留置管无法植入靶动脉内，其中腹腔动脉干过长５例，肝右动脉（靶动脉）起自肠系膜上动脉３例，靶血管迂曲３例。ＬＳＡ组气胸４例，留置管移位１２例，而ＦＡ组留置管移位１１例。移位率分别为１０．２％和１１．２％。结论：常规采取ＦＡ径路肝动脉内植入ＰＣＳ安全可行。对腹腔动脉、肝动脉解剖变异者采取ＬＳＡ法能够提高植入术成功率，降低留置管移位率
Objective: To explore the optimal pathway for the implantation of a PCS catheter in the hepatic artery. Materials and Methods: 216 patients with advanced liver cancer were enrolled in this study. 118 patients were percutaneously implanted into the hepatic artery of the left subclavian artery (LSA), and another 98 patients were implanted with PCS through the transfemoral artery (FA). Statistics the success rate and complications of the two implantation methods. Results: The implantation success rate of LSA group and FA group was 91.5% and 88.7%, respectively (P>0.05). In the LSA group, failure of implantation failed in 8 cases (8 cases failed in arterial puncture, 2 cases could not be placed in the target artery indwelling catheter), and 11 cases in the FA group failed to be implanted into the target artery by indwelling catheter. The right hepatic artery (target artery) originated from the superior mesenteric artery in 3 cases and the target vessels in 3 cases. There were 4 cases of pneumothorax in LSA group and 12 cases of indwelling tube displacement, while 11 cases of indwelling tube displacement in FA group. The shift rates were 10.2% and 11.2%, respectively. Conclusion: It is safe and feasible to implant PCS into the hepatic artery via FA route. The use of LSA for celiac artery and hepatic artery anatomy and variability can improve the success rate of implantation and reduce the rate of indwelling tube displacement.